Psychosocial determinants of relapse in ulcerative colitis: A longitudinal study
Psychosocial determinants of relapse in ulcerative colitis: A longitudinal study
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DOI：
10.1016/s0002-9270(03)00750-0
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发表时间：
2003-10-01
影响因子：
9.8
通讯作者：
Shah, S
中科院分区：
文献类型：
--
作者：
Bitton, A;Sewitch, MJ;Shah, S
OBJECTIVES: To determine the association between psychosocial characteristics and time to relapse in patients with inactive ulcerative colitis.METHODS: Sixty patients with clinically and endoscopically inactive ulcerative colitis were followed for 1 yr, or less if they relapsed. Demographic, psychosocial, and clinical data were obtained. Stressful life events (Psychiatric Epidemiology Research Interview Life Events Scale), psychological distress (Symptom Checklist-90R), and perceived stress (Perceived Stress Scale) were recorded monthly by self-report. Multivariate time-dependent Cox regression was used to identify the independent determinants of earlier time to clinical relapse.RESULTS: The patients' mean age was 39 yr (SD = 9.4), 37 (62%) were female, and 22 (37%) relapsed during the 1-yr follow-up. Univariate Cox regression indicated a weak association between number of stressful events in the preceding month and time to relapse (p = 0.09). This association strengthened in multivariate analysis (p = 0.02, hazard ratio = 1.26 per event, 95% CI = 1.04-1.53) after adjustment for significant covariates.CONCLUSIONS: After controlling for demographic and clinical variables, more recent stressful events were associated with earlier time to relapse. These findings, which support a biopsychosocial model of disease, might help clinicians identify patients who might benefit from more intensive maintenance medical therapy and behavioral medicine interventions to reduce stress and improve coping.
